Imaging group to pay $15.5 million for false claims
Diagnostic Imaging Group (DIG) in Hicksville, NY, has agreed to pay $15.5 million to resolve allegations that its diagnostic testing facility falsely billed federal and state health care programs for tests that were not performed or not medically necessary and paid kickbacks to physicians.
DIG has agreed to pay $13.65 million to the federal government and an additional $1.85 million to New York and New Jersey.
The settlement resolves allegations that DIG submitted claims to Medicare, as well as the New Jersey and New York Medicaid Programs, for 3D reconstructions of CT scans that were never performed or interpreted.
Additionally, DIG allegedly bundled certain tests on its order forms so that physicians could not order other tests without ordering the additional bundled tests, which were not medically necessary. The settlement also resolves allegations that DIG paid kickbacks to physicians for the referral of diagnostic tests.
According to the government, the kickbacks were in the form of payments that DIG made to physicians ostensibly to supervise patients who underwent nuclear stress testing. These payments allegedly exceeded fair market value and were, in fact, intended to reward physicians for their referrals.
The allegations resolved in the settlement were raised in three lawsuits filed under the qui tam, or whistleblower, provisions of the False Claims Act. The three whistleblowers, Mark Novick, MD, Rey Solano, and Richard Steinman, MD, will receive $1.5 million, $1.07 million and $209,250, respectively, as part of the settlement.
Since January 2009, the Justice Department has recovered a total of more than $19 billion through False Claims Act cases, with more than $13.4 billion of that amount recovered in cases involving fraud against federal healthcare programs.